You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging II1 Apr 2018MP36-17 USEFULNESS OF MORPHOLOGICAL CLASSIFICATION OF CLINICAL T1 RENAL CELL CANCER ON PREDICTING UPSTAGING TO PATHOLOGICAL T3 OR HIGHER Jun Teishima, Tetsutaro Hayashi, Hiroyuki Kitano, Kousuke Sadahide, Shunsuke Shinmei, Shogo Inoue, Yukiko Honda, Kazuhiro Sentani, Kazuo Awai, Wataru Yasui, and Akio Matsubara Jun TeishimaJun Teishima More articles by this author , Tetsutaro HayashiTetsutaro Hayashi More articles by this author , Hiroyuki KitanoHiroyuki Kitano More articles by this author , Kousuke SadahideKousuke Sadahide More articles by this author , Shunsuke ShinmeiShunsuke Shinmei More articles by this author , Shogo InoueShogo Inoue More articles by this author , Yukiko HondaYukiko Honda More articles by this author , Kazuhiro SentaniKazuhiro Sentani More articles by this author , Kazuo AwaiKazuo Awai More articles by this author , Wataru YasuiWataru Yasui More articles by this author , and Akio MatsubaraAkio Matsubara More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1151AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previous studies have reported that cases with clinical T1 (cT1) renal cell cancer (RCC) upstaging to pathological T3 is a risk factor to predicting postoperative recurrence after partial nephrectomy. The aim of our study was to investigate the impact of the morphological features of the enhanced computed tomography (CT) scan of cT1 renal cell cancer on predicting upstaging to pathological T3 or higher. METHODS Three hundred sixty-seven cases with cT1 RCC diagnosed from enhanced CT scans were enrolled in this study. Based on the findings from the enhanced CT scan, the cases were classified into ″round″, whose margins were smooth and round, ″lobular″, whose margins were smooth but distorted, and ″irregular″, whose margins were sharply nodular. The association of postoperative upstaging with these morphological features and other characteristics of tumors in each case were analyzed. RESULTS Of the 367 cases, 255 and 112 were diagnosed as clinical T1a (cT1a) and T1b (cT1b), respectively. Two hundred seventy-four, 33, and 60 cases were determined as round, lobular, and irregular types, respectively. One hundred eight, 188, and 71 cases were those whose RENAL nephrometry scores (RNSs) of their tumors were 6 or lower, 7 to 9, 10 or higher, respectively. Eighteen cases (4.9%) pathologically upstaged to T3a or higher. Perirenal fatty tissue invasion, renal sinus fatty tissue invasion, and venous invasion were detected in 4, 11, and 7 out of these 18 cases, respectively. One round case (0.4%), 3 lobular cases (9.1%), and 14 irregular cases (23.3%) pathologically upstaged (p<0.0001, round + lobular versus irregular). Six cases (2.4%) of cT1a and 12 cases (10.6%) of cT1b upstaged pT3a or higher (p=0.0007). Seventeen of 201 (8.5%) and 8 of 86 (9.3%) cases whose N and E factors in RNS were 3 points pathologically upstaged, while 10 of 281 (3.6%, p=00309) and 1 of 166 (0.6%, p=0.0005) cases upstaged in others, respectively. Eleven of 71 cases with RNS 10≤ pathologically upstaged while 7 of 289 cases (2.4%) upstaged in others (p<0.0001). Four of 17 cases (23.5%) with hilar tumors pathologically upstaged while 14 of 350 cases (4%) with tumors pathologically upstaged in other sites (p=0.0003). Multivariate analysis revealed that irregular finding was an independent factor in predicting upstaging to pathological T3a or higher (p=0.0003). CONCLUSIONS Evaluation of the morphological features of cT1 RCC based on enhanced CT scan is useful for predicting pathological upstaging. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e464-e465 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jun Teishima More articles by this author Tetsutaro Hayashi More articles by this author Hiroyuki Kitano More articles by this author Kousuke Sadahide More articles by this author Shunsuke Shinmei More articles by this author Shogo Inoue More articles by this author Yukiko Honda More articles by this author Kazuhiro Sentani More articles by this author Kazuo Awai More articles by this author Wataru Yasui More articles by this author Akio Matsubara More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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